Parent/Guardian Consent

Parent/Guardian Consent Form

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Action for Stammering Children (ASC) is the UK charity for children and young people who stammer, their families and the communities who support them.

We use photographic and video content to showcase the work we do and raise the profile about the charity, so that we can continue supporting children and young people who stammer, and their families, living across the UK. This consent form relates to photo and video footage involving your child. Please read it carefully and indicate whether you consent for us to use the photo and video footage recorded in our activities and promotional work. Any footage/photographs will be owned and used by ASC only in order to promote our charitable causes.

Parent/Guardian's Name(Required)

First Last

Child's Name

First Last

Your relationship with the child

Parent/guardian phone(Required)

Parent/guardian email(Required)

Home Address(Required)

Street Address Address Line 2 City ZIP / Postal Code Country

I give my consent for Action for Stammering Children to include my child in any photographs taken during charitable activities

Yes, I give my consent

No, I do not consent

I give my consent for Action for Stammering Children to include my child in any video footage recorded during charitable activities

Yes, I give my consent

No, I do not consent

I grant ASC full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the Charity’s aims. This might include (but is not limited to), the right to use them in their printed and online publicity, website, national social media, press releases, television appeals, projects, annual report and funding applications.

Yes I agree

No I do not agree

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Parent/Guardian Consent Form

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